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Long-term television viewing patterns and gray matter brain volume in midlife

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The purpose of this study was to investigate whether long-term television viewing patterns, a common sedentary behavior, in early to mid-adulthood is associated with gray matter brain volume in midlife and if this is independent of physical activity. We evaluated 599 participants (51% female, 44% black, mean age 30.3 ± 3.5 at baseline and 50.2 ± 3.5 years at follow-up and MRI) from the prospective Coronary Artery Risk Development in Young Adults (CARDIA) study. We assessed television patterns with repeated interviewer-administered questionnaire spanning 20 years. Structural MRI (3T) measures of frontal cortex, entorhinal cortex, hippocampal, and total gray matter volumes were assessed at midlife. Over the 20 years, participants reported viewing an average of 2.5 ± 1.7 h of television per day (range: 0–10 h). After multivariable adjustment, greater television viewing was negatively associated with gray matter volume in the frontal (β = − 0.77; p = 0.01) and entorhinal cortex (β = − 23.83; p = 0.05) as well as total gray matter (β = − 2.09; p = 0.003) but not hippocampus. These results remained unchanged after additional adjustment for physical activity. For each one standard deviation increase in television viewing, the difference in gray matter volume z-score was approximately 0.06 less for each of the three regions (p < 0.05). Among middle-aged adults, greater television viewing in early to mid-adulthood was associated with lower gray matter volume. Sedentariness or other facets of television viewing may be important for brain aging even in middle age.
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https://doi.org/10.1007/s11682-021-00534-4
ORIGINAL RESEARCH
Long‑term television viewing patterns andgray matter brain volume
inmidlife
RyanJ.Dougherty1· TinaD.Hoang2· LenoreJ.Launer3· DavidR.Jacobs4· StephenSidney5· KristineYae2,6
Accepted: 2 August 2021
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021
Abstract
The purpose of this study was to investigate whether long-term television viewing patterns, a common sedentary behavior, in
early to mid-adulthood is associated with gray matter brain volume in midlife and if this is independent of physical activity.
We evaluated 599 participants (51% female, 44% black, mean age 30.3 ± 3.5 at baseline and 50.2 ± 3.5years at follow-up
and MRI) from the prospective Coronary Artery Risk Development in Young Adults (CARDIA) study. We assessed televi-
sion patterns with repeated interviewer-administered questionnaire spanning 20years. Structural MRI (3T) measures of
frontal cortex, entorhinal cortex, hippocampal, and total gray matter volumes were assessed at midlife. Over the 20years,
participants reported viewing an average of 2.5 ± 1.7h of television per day (range: 0–10h). After multivariable adjust-
ment, greater television viewing was negatively associated with gray matter volume in the frontal (β = − 0.77; p = 0.01) and
entorhinal cortex (β = − 23.83; p = 0.05) as well as total gray matter (β = − 2.09; p = 0.003) but not hippocampus. These
results remained unchanged after additional adjustment for physical activity. For each one standard deviation increase in
television viewing, the difference in gray matter volume z-score was approximately 0.06 less for each of the three regions
(p < 0.05). Among middle-aged adults, greater television viewing in early to mid-adulthood was associated with lower gray
matter volume. Sedentariness or other facets of television viewing may be important for brain aging even in middle age.
Keywords Lifestyle factors· Sitting time· Volumetric MRI· Epidemiology· Cohort studies
Introduction
While it is generally accepted that a physically active life-
style is important for cognitive and brain health (Barnes &
Yaffe, 2011; Dougherty etal., 2016, 2017, 2021; Erickson
etal., 2014; Hamer & Chida, 2009; Yaffe etal., 2001), sed-
entary behavior has increasingly become a public health
focus due to evidence that it may impart unique risk for
chronic diseases (Dunstan etal., 2012; Katzmarzyk etal.,
2009). Sedentary behaviors are defined as any waking
behavior characterized by low levels of energy expenditure,
while in a seated, reclined or lying posture (Ainsworth etal.,
2000). Although a few studies have investigated sedentary
lifestyle on cognitive function and dementia risk in older
adults (Barnes & Yaffe, 2011; Falck etal., 2017; Wheeler
etal., 2017), much less is known how sedentary behaviors
influence measures of brain health in midlife (Voss etal.,
2014).
Reduction in gray matter volume measured by brain mag-
netic resonance imaging (MRI) is a marker of brain health
that often precedes cognitive impairment (Iturria-Medina
etal., 2016; Jack etal., 2018). Gray matter declines (i.e.,
atrophies) during midlife (Raz etal., 2005; Resnick etal.,
2003) and longitudinal patterns of atrophy predict future
cognitive function and dementia onset (Allison etal., 2019;
Driscoll etal., 2009). Therefore, strategies that preserve
gray matter volume in midlife may mitigate the progression
of cognitive decline. The few recent studies on the effects
* Ryan J. Dougherty
rdoughe7@jhu.edu
1 Department ofEpidemiology, Johns Hopkins Bloomberg
School ofPublic Health, Johns Hopkins University, 2024 E.
Monument St., Suite 2-700, Baltimore, MD21205, USA
2 San Francisco VA Health Care System, SanFrancisco, CA,
USA
3 National Institute onAging, Bethesda, MD, USA
4 University ofMinnesota, Minneapolis, MN, USA
5 Kaiser Permanente Division ofResearch, Oakland, CA, USA
6 University ofCalifornia, San Francisco, SanFrancisco, CA,
USA
/ Published online: 6 September 2021
Brain Imaging and Behavior (2022) 16:637–644
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Importance Prolonged sitting, particularly watching television or videos, has been associated with increased risk of multiple diseases and mortality. However, changes in sedentary behaviors over time have not been well described in the United States. Objective To evaluate patterns and temporal trends in sedentary behaviors and sociodemographic and lifestyle correlates in the US population. Design, Setting, and Participants A serial, cross-sectional analysis of the US nationally representative data from the National Health and Nutrition Examination Survey (NHANES) among children aged 5 through 11 years (2001-2016); adolescents, 12 through 19 years (2003-2016); and adults, 20 years or older (2003-2016). Exposures Survey cycle. Main Outcomes and Measures Prevalence of sitting watching television or videos for 2 h/d or more, computer use outside work or school for 1 h/d or more, and total sitting time (h/d in those aged ≥12 years). Results Data on 51 896 individuals (mean, 37.2 years [SE, 0.19]; 25 968 [50%] female) were analyzed from 2001-2016 NHANES data, including 10 359 children, 9639 adolescents, and 31 898 adults. The estimated prevalence of sitting watching television or videos for 2 h/d or more was high among all ages (children, 62% [95% CI, 57% to 67%]; adolescents, 59% [95% CI, 54% to 65%]; adults, 65% [95% CI, 61% to 69%]; adults aged 20-64 years, 62% [95% CI, 58% to 66%]; and ≥65 years, 84% [95% CI, 81% to 88%] in the 2015-2016 cycle). From 2001 through 2016, the trends decreased among children over time (difference, −3.4% [95% CI, −11% to 4.5%]; P for trend =.004), driven by non-Hispanic white children; were stable among adolescents (−4.8% [95% CI, −12% to 2.3%]; P for trend =.60) and among adults aged 20 through 64 years (−0.7% [95% CI, −5.6% to 4.1%]; P for trend =.82); but increased among adults aged 65 years or older (difference, 3.5% [95% CI, −1.2% to 8.1%]; P for trend =.03). The estimated prevalence of computer use outside school or work for 1 h/d or more increased in all ages (children, 43% [95% CI, 40% to 46%] to 56% [95% CI, 49% to 63%] from 2001 to 2016; difference, 13% [95% CI, 5.6% to 21%]; P for trend <.001; adolescents, 53% [95% CI, 47% to 58%] to 57% [95% CI, 53% to 62%] from 2003 to 2016, difference, 4.8% [95% CI, −1.8% to 11%]; P for trend =.002; adults, 29% [27% to 32%] to 50% [48% to 53%] from 2003 to 2016, difference, 21% [95% CI, 18% to 25%]; P for trend <.001). From 2007 to 2016, total hours per day of sitting time increased among adolescents (7.0 [95% CI, 6.7 to 7.4] to 8.2 [95% CI, 7.9 to 8.4], difference, 1.1 [95% CI, 0.7 to 1.5]) and adults (5.5 [95% CI, 5.2 to 5.7] to 6.4 [95% CI, 6.2 to 6.6]; difference, 1.0 [95% CI, 0.7 to 1.3]; P for trend <.001 for both). Conclusions and Relevance In this nationally representative survey of the US population from 2001 through 2016, the estimated prevalence of sitting watching television or videos for at least 2 hours per day generally remained high and stable. The estimated prevalence of computer use during leisure-time increased among all age groups, and the estimated total sitting time increased among adolescents and adults.